“…In both study groups, physicians were informed by letter if patients reported any suicidal ideation and immediately when patients were identified as being at high risk for suicide according to prespecified guidelines. Other sources detail the PROSPECT treatment algorithm and implementation, including the role of the care manager (29), strategy for pharmacotherapy (28), management of suicidal ideation (30,31), and types and proportions of treatment received over time by patients in practices randomly assigned to the intervention or to usual care (14,32).…”
“…In both study groups, physicians were informed by letter if patients reported any suicidal ideation and immediately when patients were identified as being at high risk for suicide according to prespecified guidelines. Other sources detail the PROSPECT treatment algorithm and implementation, including the role of the care manager (29), strategy for pharmacotherapy (28), management of suicidal ideation (30,31), and types and proportions of treatment received over time by patients in practices randomly assigned to the intervention or to usual care (14,32).…”
“…The patients in the intervention group ceased to have identifiable suicidal ideation more rapidly, and their depression diminished more readily and more completely compared with the treatment-as-usual group, although the differences among the groups with respect to remission rates were not significantly different at the 1-year mark [34]. The proportion of patients receiving any form of psychotherapy was greater in the intervention group, and IPT use was noted to increase in the intervention practices over time [35]. .…”
Section: Ongoing Research Using Ipt With Older Adultsmentioning
Interpersonal psychotherapy (IPT) has been shown to be an efficacious evidence-based treatment for major depression in combination with antidepressant medication, as a maintenance treatment in combination with medication, and as monotherapy (with placebo). After reviewing the salient features of IPT that make it a good fit for treating older patients, I summarize the extant literature. New adaptations of IPT for depressed older adults with cognitive impairment are delineated. An argument is articulated for why IPT may be the ideal psychotherapy for older patients.
“…The care manager also could provide brief evidence-based psychotherapy such as problem-solving therapy, [39][40][41][42] if counselors are not available to deliver extended but time-limited therapies, such as cognitive behavioral therapy [43][44][45][46] or interpersonal therapy. [47][48][49] Step 8. Specify activities of other depression care team members Typically, PCPs are expected to be responsible for detecting and diagnosing depression, prescribing antidepressants, and referring patients to the collaborative care program.…”
Section: Step 3 Specify Target Patients and Identification Proceduresmentioning
Numerous studies have demonstrated that collaborative care (care management) for depression improves outcomes, yet few clinics have implemented this evidence-based practice. To promote adoption of this best practice, our objective was to describe the steps needed to tailor collaborative care models for local needs, resources, and priorities while maintaining fidelity to the evidence base. Based on lessons learned from 2 multisite Veterans Affairs implementation studies conducted in 2 different clinical, organizational, and geographic contexts, we describe in detail the steps needed to adapt an evidence-based collaborative care program for depression for local context while maintaining highly fidelity to the research evidence. These steps represent a detailed checklist of decisions and action items that can be used as a tool to plan the implementation of a collaborative care model for depression. We also identify other tools (eg, decision support systems, suicide risk assessment) and resources (eg, training materials) that will support implementation efforts. These implementation tools should help clinicians and administrators develop informed strategies for rolling out collaborative care models for depression.
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